All Medicaid billing entities listing WILSON, SIMONE (DIRECTOR OF CREDENTIALING & ENROLL) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Maryland | 1 | $188K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | TIDEWATER LLC | CHARLOTTE HALL, MD | General Practice Dentistry | $188K |